ASPIRIN AND WARFARIN?????

[poppystorey]

Good morning ,Having just had an angiogram I have now started warfarin 3mgs a day .Previous I have been taking 75mgs of dispersable aspirin. Is it advisable to be on both ,or should i question this ,Thankyou poppystorey

[rupert12]

I was on aspirin to start with, then I was put on Warfarin, the nurse at the warfarin clinic said I should continue the aspirin until my INR reached 2, which it did in just under two weeks, then I stopped the aspirin (all this being under the guidance of the clinic) When you first go on warfarin your INR levels should be checked very regularly, so there is no danger in your INR going too high - hope that helps.

[squiffy]

I have recently been put on warfarin and was told by the pharmacist to speak to my doctor as I too was on aspirin. My doctor stopped the aspirin straight away. I would check with your doctor too. I was told at the warfarin clinic last week to stop the aspirin as my INR levels were settling down and told them that I had already stopped as advised by my doctor. They said that is fine.

[Beancounter Volunteer]

Hi Poppy

It's not quite as clear-cut.

For certain, and just about everyone agrees with this, aspirin is NOT sufficient for anyone with A Fib to be anti-coagualated, and anyone who is prescribed Aspirin only should go and see their doctor immediately.

It's a heated debate and you will find many articles in newspapers etc saying aspirin is as good as warfarin, and for A Fib I think aspirin loses big time.

However Aspirin and Warfarin (or the other anti-coagulants) work in different ways, and if you have problems other than A Fib, and the classic ones here would be higher than usual calcium count, or higher than usual Cholesterol, then aspirin can play a useful adjunct to the warfarin, as this works better with the factors which can cause heart disease.

In fact I am also on 75mg dispersable aspirin, as well as warfarin, and in my case for two different reasons.

You said you had an angiogram, did this discover anything? do you have the results of this?

Certainly go and see your doctor, however the 75mg is not a large dose and if there are good reasons for you to stay on the aspirin as well as the warfarin, then I am certain he/she will explain them to you.

As others have stated this will be taken into account with your (at present probably weekly) blood tests, but certainly talk to the anti-coag nurse, but preferably your doctor.

Good luck

Ian

[poppystorey in reply to Beancounter]

thank you for such a quick reply ,my results were no blocked artieries or heart desease ,just this rapid heart rate and irregular beat i am on statins .my inr was 1.0 last week on first visit to clinic with the goal of 2.5 .I will speak to my doctor after my visit to the warfarin clinic in the morning,thank you .poppystoreyt

[BobD Volunteer]

Hi poppystorey. Ian has it right as usual although it is unusual to be on both unless there is a seperate medical reason. There seems to have been a change in methods regarding getting people onto a therapeutic INR. When I started warfarin about 7 years ago they put me on 10mg a day for two days and then did daily INR checks , adjusting the dose until I settled in the 2-3 range. That way I was covered within days. Now many clinics seem to creep up on it over weeks which I feel is an odd way to do it adding 1/2mg at a time. Still the important thing is that you are being looked after.

BobD

[TheStand]

poppystorey,

As Bob said, it is unusual to be taking both an anticoagulant and aspirin unless there are separate issues requiring both. Aspirin causes the reduction of platelets sticking together which heals a blood vessel that breaks or leaks added to the blood thinner which slows down clotting, this could be a problem. Although a low dose aspirin would probably not be a major concern. I would ask your Dr but not be overly worried about it. You have enough worries with the AF.

Bob, I think they changed the ramp time for warfarin because there were too many cases where a patient overshot the desired levels by a large amount. One check shows an INR of 1.7 and then 3 days later a reading of 3.6 and since the patient had already taken thier meds that could get a lot higher before a reduction in dose would help. So they just decided to creep up on the desired level.

Tim

[Chris-S]

Hi all, I am on low dose aspirin and warfarin at present . It was decided that as I have been on aspirin for about 18 years because of severe coronary artery disease I should remain on it. I have only been taking warfarin for 10 days or so and am not up to the recommended INR yet so we shall see how it goes !

Chris

[TheStand in reply to Chris-S]

Hi Chris, Yes with the CAD it is a good idea to be on the low dose aspirin. I guess it is either 75 or 81mg? With CAD the chance of a blockage caused by platelets sticking together is a risk and that is what the aspirin is for.

I would not worry to much about taking both. Most problems have occurred when a high dose usually 325mg or higher) is used in combination with a blood thinner. At your level I think the low risk is worth the possible benefit.

Tim